They may be bad, but they can also do some good. That’s the balance the med field is supposed to be concerned with. I think what many on this thread acknowledge is that, if you haven’t been in massive pain, you don’t know. I’m pretty pain tolerant and medication averse. That didn’t matter after major surgery and a few kidney stone incidents. For the latter, I now know what to try first, before the hydrocodone.
Amen to that! My late father, in his mid-80s, suffered from severe stenosis and yes, he absolutely was addicted to his painkillers (I forget which one now). This was only a problem when he was hospitalized, and the attending doc would invariably NOT prescribe it for his discharge. The care home couldn’t give it to him if it wasn’t prescribed by the most recent doctor, so I’d have to call his primary to get it re-prescribed. Fortunately she was on the same page as we were about quality of life.
One hospital discharging doctor told me, “Stopping the morphine would help his cognition” and blew me off when I told him that his cognition just wasn’t all that important to us at that point. When he was in pain, NOTHING good happened, and the only thing we cared about was that he was happy and comfortable. Couldn’t get that through the doctor’s head.
And now with 92-year-old Mom, who takes Hydrocodone for her arthritis, same thing. She has dementia and her life is quite restricted, but she’s happy and pain free and that’s all we care about. But as of 1/1/15, that prescription can no longer be auto-refilled, or transmitted to the pharmacy by phone, email, or fax. Each month, I have to call the doctor and request another Rx, then have to personally (they check ID) pick it up at the doctor’s office.
I understand the concern for younger people, who have some kind of life ahead of them, or who support a family or take care of others, or otherwise contribute to society. But someone like my dad or mom? Come on.
@arabrab I had surgery recently and was shocked when I filled the Rx (Hydocodone). The bottle was full! I took 3 the first day, 3 the second day, and 1 the third day. As I posted above, I’ve seen both of my parents get hooked and I was willing to deal with some pain to avoid that. (I know that post-surgical pain is a whole different kettle of fish than chronic pain. )
I’m supposed to take the rest of the pills to a sheriff’s station to dispose of them.
Not sure if this has been mentioned, but one of the biggest concerns with the elderly on pain meds is the increased risk of falls. A fall which results in a broken hip/leg often leads to months of rehab, permanent disability, multiple complications, etc. Falls are “the beginning of the end” for many frail elderly folks, and reducing the risk of falls is one of the main reasons docs try to avoid these meds.
Re: #161, #162
Looks like the physicians in question are doing it wrong both ways. The new guidelines exclude palliative care which would describe the situations you describe in #191, but it seems that they are still careless with over-prescribing opioids in other situations as you describe in #192.
UCB, you can’t take someone’s experience and say “they” as though it is generalizable… especially when many of have contrary experiences.
Yes, “some” doctors seem to be over-prescribing but not “they” as though “they” are a monolithic block.
Ucb, my dad died in 2013, before the new law came into effect. Back then I think it was up to the doctor. Hospital docs just seemed to have a distaste for maintenence morphine, regardless of the situation. The primary doc had the big picture and judged that relieving Dad’s severe unrelenting pain was the best of bad choices. In Mom’s case, all I know is that if I don’t jump through those hoops, she doesn’t get her drugs. Probably they are erring on the side of staying out of trouble with the feds, given what a hot issue this is right now. But thanks, I will ask about the palliative care exemption.
Regarding the excessive amount of hydrocodone I was given, yeah, I don’t understand it at all. I won’t pursue it because I’ll probably never see this doctor again.
For those of you in the field, what is there for non-narcotic pain relief?
My H has put up with severe pain from spinal nerve damage for years. After each surgery they put him on opioids which shut down his digestive system entirely. Is there any hope for something new on the horizon?
TENS units that are handheld are helpful for SOME folks with SOME types of pain. Physical therapy has been much more effective than expected for AG’s chronic back, neck and shoulder pain. I also bought a batter operated Shiatsu massager that provides some relief to H and D.
I know this isn’t the answer you were looking for, but there are prescription medications for people with specific slow bowel movements due to narcotic usage. My use was short-lived - about four days after surgery, but because it was abdominal surgery, they were more concerned about getting things moving again, so from the get go, they had me on Senokot… no waiting to see if I ‘became’ stopped up. I assumed that’s what they do for other people who are going to require narcotic pain-relievers after surgery. Get on top of it instead of waiting for it to happen.
I have chronic lower back pain and a little TENS unit, called the WiTouch by Hollywog, has been helpful. Dh was skeptical until he finally tried it and was pleased with the difference it made. I tend to run it at a stronger setting than he uses and do at least two cycles at a time, three if the pain has been worse than usual. It’s of limited use, but for us it’s often been a good alternative to Rx meds.
Some drug company apparently saw a market for a drug for this, so they developed a drug and started doing direct-to-consumer advertising for it. (But will that drug have undesired effects that some other drug will be marketed to counteract?)
Dragonmom, medical marijuana can relieve pain, without the side effects of narcotics.
Those of us subject to random drug screens for work would never be able to utilize that. I’ve often wondered it it would help my back and neck pain, but as long as it remains a violation of federal law, I would be fired for that, even if it was legalized in my state.
Had never thought of that. Here’s some background http://www.nolo.com/legal-encyclopedia/can-i-fired-because-i-medical-marijuana-disability.html
I had Percocet post-op total knee replacement and I was concerned. I hated that at 4 weeks out, I still needed it a couple of times a day. Then, suddenly, I didn’t need it any more and just took Tylenol. Whew!
I know a young man with chronic back pain who takes Vicodin. Yes, I’m concerned for him as he’s only like 36 years old, has three young children but the poor man has back issues from top to bottom, and has had multiple surgeries and is still suffering. It scares me for him. I’m suspicious…of developing issues because of what he posts on FB. : (
I think addiction research would be more beneficial to more people than restricting pain meds.>>>>>>>>>>>>
Hear, hear. I think every person needs to know if they have an addiction gene, if that ever gets identified. At least a person could be forewarned. As for developing non-addictive potent pain killers, I just simply don’t know. I hope it’s an area of high research, to find a pathway that can be broken but doesn’t create euphoria.
I personally never experienced any euphoria or high while on the opiods. Nevertheless, I wanted off them as soon as possible.
I’m registered in Va, though I’m now retired and I worked in hospital pharmacy. But Va has a monitoring program that has shown some success. That said…isn’t that also what is driving folks to change over to heroin?? So, how successful is that, right? Not at all.
http://www.msv.org/MainMenuCategories/MemberCenter/Knowledgebase/Public-Health-Government-Programs/PMP/The-importance-of-participation-in-Virginias–.aspx
Pharmacists can also prescribe, in some settings>>>>>>>>>>
Vague post. Pharmacists are very, extremely limited in prescribing and generally it’s in a hospital setting for inpatients. Pharmacists cannot prescribe narcotics, not ever, inpatient or outpatient.
Also, retail pharmacists are never, ever required to fill any and all prescriptions presented to them.
Providers can no longer prescribe refills for schedule II narcotics.>>>>>>>>>>>
Schedule II’s have NEVER been refillable.